Preoperative imaging assessment of neurogenic tumors at the thoracic apex to determine suitability for robotic surgery.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki
{"title":"Preoperative imaging assessment of neurogenic tumors at the thoracic apex to determine suitability for robotic surgery.","authors":"Mariko Fukui, Takeshi Matsunaga, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki","doi":"10.1007/s11748-025-02140-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To predict suitability for robotic surgery from preoperative images in patients with neurogenic tumors at the thoracic apex.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent robot-assisted thoracic surgery for tumors at the thoracic apex located cranial to the first rib. Patient characteristics, preoperative computed tomography findings, operative time, operative bleeding, rate of conversion to thoracotomy, and surgical outcomes were reviewed. We examined the image characteristics of converted cases and cases with an operative time exceeding 2 h.</p><p><strong>Results: </strong>Twenty-five patients underwent robot-assisted thoracic surgery for apical neurogenic tumors, and 64% of these tumors were schwannomas. Ninety-day mortality was 0%; however, postoperative neurological complications were common (Horner's syndrome: 56%, bronchial plexus disorder: 36%) even after enucleation. However, almost all symptoms disappeared within 1 year. Persistent nerve complications were observed in two patients (8%). Tumors < 3 cm did not interfere with vessel visualization and were resected within 2 h. Patients with an unconfirmed boundary with the vessels were considered for an anterior transcervical thoracic approach for safety reasons.</p><p><strong>Conclusions: </strong>Robot-assisted thoracic surgery for apical neurogenic tumors is feasible; however, postoperative neurological symptoms are common within 1 year after surgery. Thoracotomy should be considered for patients with tumors in contact with the subclavian vessels. Preparations for a transmanubrial approach may be necessary for such cases.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"General Thoracic and Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11748-025-02140-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To predict suitability for robotic surgery from preoperative images in patients with neurogenic tumors at the thoracic apex.

Methods: This retrospective cohort study included patients who underwent robot-assisted thoracic surgery for tumors at the thoracic apex located cranial to the first rib. Patient characteristics, preoperative computed tomography findings, operative time, operative bleeding, rate of conversion to thoracotomy, and surgical outcomes were reviewed. We examined the image characteristics of converted cases and cases with an operative time exceeding 2 h.

Results: Twenty-five patients underwent robot-assisted thoracic surgery for apical neurogenic tumors, and 64% of these tumors were schwannomas. Ninety-day mortality was 0%; however, postoperative neurological complications were common (Horner's syndrome: 56%, bronchial plexus disorder: 36%) even after enucleation. However, almost all symptoms disappeared within 1 year. Persistent nerve complications were observed in two patients (8%). Tumors < 3 cm did not interfere with vessel visualization and were resected within 2 h. Patients with an unconfirmed boundary with the vessels were considered for an anterior transcervical thoracic approach for safety reasons.

Conclusions: Robot-assisted thoracic surgery for apical neurogenic tumors is feasible; however, postoperative neurological symptoms are common within 1 year after surgery. Thoracotomy should be considered for patients with tumors in contact with the subclavian vessels. Preparations for a transmanubrial approach may be necessary for such cases.

胸椎尖端神经源性肿瘤的术前影像学评估,以确定机器人手术的适用性。
目的:从胸椎顶点神经源性肿瘤患者的术前图像预测机器人手术的适用性。方法:这项回顾性队列研究包括接受机器人辅助胸外科手术的患者,这些患者位于第一肋骨的胸尖部。回顾了患者特征、术前计算机断层扫描结果、手术时间、手术出血、转开胸率和手术结果。结果:25例患者接受了机器人辅助胸外科手术治疗根尖神经源性肿瘤,其中64%为神经鞘瘤。90天死亡率为0%;然而,术后神经系统并发症是常见的(霍纳综合征:56%,支气管丛障碍:36%),即使在去核后。但几乎所有症状在1年内消失。2例患者(8%)出现持续性神经并发症。结论:机器人辅助胸外科手术治疗根尖神经源性肿瘤是可行的;然而,术后神经系统症状在术后1年内很常见。肿瘤与锁骨下血管接触的患者应考虑开胸手术。在这种情况下,可能需要为经柄入路做准备。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
General Thoracic and Cardiovascular Surgery
General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine
CiteScore
2.70
自引率
8.30%
发文量
142
期刊介绍: The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信